Cataract

What is cataract?

Cataract is clouding of the eye's natural lens, which leads to a gradual reduction in vision.

The diagnosis can be made at various stages, even when vision remains good and the patient notices no symptoms. This is why regular examination as part of a comprehensive check-up helps with early recognition and monitoring planning.

The most common cause is age-related degeneration of the lens. Over time, the lens loses its clarity and takes on a whitish, yellowish or brownish tint. The clinical picture and rate of progression are individual; the decision to operate is discussed based on vision, needs, and safety for driving or work.

Besides age, other factors (e.g. injury, medication, systemic disease) can accelerate or modify the presentation of cataract; biomicroscopy and measurement of corrected visual acuity complete the assessment before any decision.

Managing cataract

The only definitive treatment is surgery. The timing of surgery is individualised, depending on:

• The patient's visual needs
• Daily functional ability
• The degree of discomfort

Some patients choose early surgery (e.g. for driving or work), while in other cases monitoring is recommended until vision is more significantly affected. The decision is always made in partnership with the ophthalmologist, after weighing benefits and risks. Details of the procedure are on the cataract surgery page.

In bilateral cataract, the second eye can be scheduled a short time after the first, following clinical judgement and assessment of the tolerance and vision of the first eye.

What does the procedure involve?

Cataract surgery is now a modern, safe procedure performed under local anaesthesia and lasting only a few minutes. The patient usually returns home the same day, with rapid visual recovery.

During the procedure:

• The clouded natural lens is removed
• An artificial intraocular lens (IOL) is implanted, which remains permanently in place

The choice of IOL is linked to your refractive needs and lifestyle; for more options see premium intraocular lenses.

What is phacoemulsification?

The majority of procedures are performed using the phacoemulsification technique.

The lens is:

• Fragmented with ultrasound
• Liquefied and removed by aspiration

The technique allows very small incisions, usually without stitches, and rapid recovery. The IOL is then implanted and the eye's normal anatomy is restored.

Phacoemulsification is combined with modern measurement and safety systems in the operating room, minimising trauma to the cornea and keeping intraocular pressure under stable control throughout the procedure.

Intraocular lens (IOL)

The IOL is a core part of the procedure and remains functional for life. After healing, vision usually returns to a very satisfactory level.

In some cases, secondary clouding (PCO) of the posterior capsule may occur later, which is easily treated with YAG laser; details at YAG laser capsulotomy. For measurement and glasses after the procedure, refraction and eyeglasses prescription is often part of the postoperative plan.

Types of intraocular lenses

The choice is individualised, depending on the patient's needs and lifestyle. For example:

• Monofocal: good vision at one distance – glasses are usually still needed
• Multifocal: improved vision at near and far, with reduced dependence on glasses
• EDOF: good vision across a range of distances, with a more natural quality of vision
• Toric: correction of astigmatism

For more detail on the technologies and choosing an option, see premium intraocular lenses.

The final degree of spectacle independence depends on the type of IOL, astigmatism, biometry accuracy and the patient's expectations; discussing this before surgery reduces disappointment after recovery.

Possible risks

The procedure is highly safe; however, as with any surgery, rare complications exist:

• Endophthalmitis
• Macular oedema or retinal detachment
• Corneal clouding
• Intraocular haemorrhage
• IOL displacement
• Need for repeat surgery

Serious complications are extremely rare. Preoperative assessment, following instructions and postoperative monitoring further reduce the risk. For general information about the practice: services; for appointments: contact.

In case of unusual pain, sudden vision loss, marked redness or discharge, contact your ophthalmologist immediately, or follow the emergency instructions you received on leaving the operating facility.